Predictions of clinical application of the cardiac dynamics based on the proportions of entropy and Zipf/Mandelbrot law in patients with acute coronary syndrome and cardiogenic shock

Two physical methodologies for cardiac dynamic evaluation has been developed, one of them was based in probability and entropy, and the other one was based in the Zipf-Mandelbrot law. These methodologies have allowed the quantitative evaluation of cardiac dynamic, differentiating normality, disease, and evolution among these. In order to simultaneously apply both methodologies for differentiate normality of acute coronary syndrome, a blind study was conducted, taking the holter of 50 subjects with normal cardiac dynamic and 50 with Acute Coronary Syndrome (ACS) who developed Acute Myocardial Infarct (AMI) and Cardiogenic Shock (CS). The value of the maximum and minimum heart rate for each hour was taken, as well the number of beats, at minimum 21 hours. For the first methodology the values of probability, entropy and proportions of the entropy of consecutive pairs of heart rates in numerical attractors were calculated. For the second, Zipf-Mandelbrot law was applied to cardiac frequencies grouped in ranges of 15 beats/min finding the degree of complexity of each dynamics and establishing its mathematical diagnosis. Subsequently sensitivity, specificity, Positive Predictive Value and Kappa coefficient were calculated to evaluate the concordance between each of the methodologies and conventional clinical diagnosis. It was shown that the methodologies differentiate normal dynamics of Acute Coronary Syndrome who developed IAM and Cardiogenic Shock, with sensitivity and specificity values of 100% and Kappa coefficient of 1, showing that physical and mathematical methodologies can evaluate more specifically the ACS, AMI and CS.